Medical plug delivery devices with a rotatable magazine and related components and methods

ABSTRACT

Medical devices for delivering compositions or medical articles to a patient are disclosed. The medical plug delivery devices can include a fluid delivery device (e.g., a syringe), a frame, and a rotatable magazine. The rotatable magazine can include a plurality of chambers that each hold a composition or a medical article (e.g., a medical plug). By rotating the rotatable magazine relative to the frame, material within the chambers of the rotatable magazine can be sequentially deployed to a patient.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.16/557,672, filed on Aug. 30, 2019, and titled MEDICAL PLUG DELIVERYDEVICES WITH A ROTATABLE MAGAZINE AND RELATED COMPONENTS AND METHODS,which is a continuation of U.S. application Ser. No. 15/479,149, filedon Apr. 4, 2017 and now issued as U.S. Pat. No. 10,398,420, which istitled MEDICAL PLUG DELIVERY DEVICES WITH A ROTATABLE MAGAZINE ANDRELATED COMPONENTS AND METHODS, which claims priority to U.S.Provisional Application No. 62/317,914 filed Apr. 4, 2016, titledDEVICES WITH A ROTATABLE MAGAZINE FOR DELIVERING MEDICAL PLUGS, and toU.S. Provisional Application No. 62/354,493 filed Jun. 24, 2016, titledMEDICAL DELIVERY DEVICES WITH A ROTATABLE MAGAZINE AND RELATEDCOMPONENTS AND METHODS, and to U.S. Provisional Application No.62/317,830 filed Apr. 4, 2016, titled DEVICES FOR DELIVERING MULTIPLEMEDICAL PLUGS, the contents of each of these applications are herebyincorporated by reference in their entireties.

TECHNICAL FIELD

The present disclosure relates generally to the field of medicaldevices. More particularly, some embodiments relate to medical devicesfor delivering compositions or medical articles (e.g., medical plugs) toa patient. Related methods are also disclosed.

BRIEF DESCRIPTION OF THE DRAWINGS

The written disclosure herein describes illustrative embodiments thatare non-limiting and non-exhaustive. Reference is made to certain ofsuch illustrative embodiments that are depicted in the figures, inwhich:

FIG. 1 is a perspective view of a medical plug delivery device.

FIG. 2 is another perspective view of the medical plug delivery deviceof FIG. 1 , with the syringe removed for clarity.

FIG. 3 is a back end view showing a proximal end of the medical plugdelivery device of FIGS. 1-2 , with the syringe removed for clarity.

FIG. 4 is a front end view showing a distal end of the medical plugdelivery device of FIGS. 1-3 , with the syringe removed for clarity.

FIG. 5 is a cross-sectional view of a portion of the medical plugdelivery device of FIGS. 1-4 .

FIG. 6 is an exploded view of a portion of the medical plug deliverydevice of FIGS. 1-5 .

FIG. 7 is another exploded view of a portion of the medical plugdelivery device of FIGS. 1-6 .

FIG. 8 is a perspective view of another embodiment of a medical plugdelivery device.

FIG. 9 is another perspective view of the medical plug delivery deviceof FIG. 8 , with the syringe removed for clarity.

FIG. 10 is a cross-sectional view of a portion of the medical plugdelivery device of FIGS. 8-9 .

FIG. 11 is an exploded view of a portion of the medical plug deliverydevice of FIGS. 8-10 .

FIG. 12 is another exploded view of a portion of the medical plugdelivery device of FIGS. 8-11 .

FIG. 13 is a proximal end view of the medical plug delivery device ofFIGS. 8-12 with the selector in a first position.

FIG. 14 is a proximal end view of the medical plug delivery device ofFIGS. 8-13 with the selector in a second position.

FIG. 15 is a side view of another embodiment of a medical device fordelivering a plug.

FIG. 16 is a front view of a plug holder for the medical device of FIG.15 .

FIG. 17 is a cross-sectional front view of the plug holder of FIG. 16taken through plane 17-17 of FIG. 18 .

FIG. 18 is a top view of the plug holder of FIGS. 16 and 17 .

FIG. 19 is a bottom view of the plug holder of FIGS. 16-18 .

FIG. 20 is a side view of the plug holder of FIGS. 16-19 .

FIG. 21 is a cross-sectional perspective view of a resilient adaptor ofthe plug holder of FIGS. 16-20 , taken through a plane in the positionindicated by plane 17-17 of FIG. 18 .

FIG. 22 is a cross-sectional view of a plug magazine of the plug holderof FIGS. 16-21 , taken through a plane in the position indicated byplane 17-17 of FIG. 18 .

FIG. 23 is a cross-sectional view of a plug magazine of the plug holderof FIGS. 16-22 taken through plane 23-23 of FIG. 17 .

DETAILED DESCRIPTION

Medical plug delivery devices may be used to deliver compositions and/ormedical articles to a patient. For example, some medical plug deliverydevices may be used to deliver medical plugs (such as pledgets) into apatient's body. Medical plugs may be inserted into voids to, inter alia,partially or completely fill one or more wound sites, to occlude thepassage of fluid through a lumen, to induce blood coagulation, toprevent or reduce leakage of biological fluid, and/or to provide ascaffold to promote and/or permit tissue growth.

For instance, during a biopsy procedure, a practitioner may insert anintroducer sheath into a patient by placing a trocar within anintroducer sheath such that a pointed distal end of the trocar protrudesfrom the distal end of the introducer sheath. With the pointed end ofthe trocar protruding from the introducer sheath, the trocar and theintroducer sheath may together be inserted into the patient. Once theintroducer sheath is positioned within the patient, the trocar may bewithdrawn from the introducer sheath. At this stage of the procedure,the introducer sheath provides a conduit that allows access to apatient's internal bodily tissue.

A cutting device (e.g., a needle or some other device configured toobtain bodily samples) may then be inserted through the introducersheath. Once the cutting device reaches the internal tissue, the cuttingdevice may be used to excise (e.g., cut out) internal tissue from thepatient. Such excision may leave behind a void in the space that wasoccupied by internal tissue.

In some circumstances, it may be advantageous to deliver one or moremedical plugs into the void created by tissue that was excised duringthe biopsy procedure. For example, in some embodiments, one or moremedical plugs may be inserted into the void to at least partially fillthe space created by the void, to promote blood coagulation at the woundsite, and/or to provide a scaffold to promote or permit tissue regrowth.

Medical plugs may be inserted into a void in other medical procedures aswell. For example, medical plugs may be delivered to block fluid flowthrough a lumen. In other words, medical plugs may be delivered asembolic agents to prevent the flow of fluid to a particular location.Medical plugs may be delivered to various other locations in a patient'sbody, or may be delivered under alternative circumstances or fordifferent purposes.

Some medical plug delivery devices and related components, as describedin greater detail below, may be configured to facilitate delivery ofmultiple medical articles (e.g., medical plugs) into a patient's body.The use of a single device to deliver multiple medical plugs may providesignificant advantages, such as facilitating delivery of multiple plugsto fill a relatively large site, or facilitating the delivery of singlemedical plugs to multiple locations (e.g., wound sites) within thepatient. In some circumstances, the medical plug delivery devices aredesigned to facilitate both wetting (e.g., hydration) and delivery ofthe medical plugs through a lumen to one or more interior regions withina patient.

Alternatively, some medical plug delivery devices disclosed herein maybe used to deliver one or more medicaments (e.g., drugs) to a patient.In some embodiments, one or more medicaments may be disposed (e.g.,preloaded) as a solid (e.g., a powder) within one or more chambers of amagazine of the medical plug delivery device. The medicaments may thenbe hydrated and delivered to a patient. In some circumstances, suchdevices may be used to deliver multiple doses of a medicament or toselect the appropriate dose from among various doses of the medicament.In some embodiments, each chamber may include a different medicament.

One of ordinary skill in the art, with the benefit of this disclosure,will understand that this disclosure relates broadly to the delivery ofcompositions and/or medical articles (e.g., medical plugs) for variouspurposes, and is not limited to the specific contexts discussed herein.Further, although some medical plug delivery devices are described belowwith specific reference to the delivery of medical plugs, such devicesmay alternatively, in some cases, be used to deploy some other medicalarticle(s) or medicament(s).

The components of the embodiments as generally described and illustratedin the figures herein can be arranged and designed in a wide variety ofdifferent configurations. Thus, the following more detailed descriptionof various embodiments, as represented in the figures, is not intendedto limit the scope of the present disclosure, but is merelyrepresentative of various embodiments. While various aspects of theembodiments are presented in drawings, the drawings are not necessarilydrawn to scale unless specifically indicated.

The phrase “coupled to” is broad enough to refer to any connection orcoupling between two or more entities. Two components may be coupled toeach other even though they are not in direct contact with each other.For example, two components may be coupled to each other through anintermediate component. The phrase “fluid communication” is broad enoughto refer to arrangements in which a fluid can flow from one element toanother element when the elements are in fluid communication with eachother.

The terms “proximal” and “distal” are opposite directional terms. Thedistal end of a device or component is the end of the component that isfurthest from the practitioner during ordinary use. The proximal endrefers to the opposite end, or the end nearest the practitioner duringordinary use. The term “void” relates to regions or openings within apatient's body to which a medical plug may be delivered.

FIGS. 1-7 provide alternative views of a medical plug delivery device100 (or portions thereof) for delivering compositions and/or medicalarticles to a patient. More particularly, FIG. 1 provides a perspectiveview of the medical plug delivery device 100. FIG. 2 provides analternative perspective view of the medical plug delivery device 100,with a syringe 102 removed for clarity. FIG. 3 provides a proximalend-on view of the medical plug delivery device 100, with the syringe102 removed for clarity. FIG. 4 provides a distal end-on view of aportion of the medical plug delivery device 100, with the syringe 102removed for clarity. FIG. 5 is a cross-sectional view of a portion ofthe medical plug delivery device 100. FIGS. 6 and 7 provide alternativeexploded views of a portion of the medical plug delivery device 100.

As depicted in FIGS. 1-7 , the medical plug delivery device 100 mayinclude a fluid delivery device such as the syringe 102, a frame 110, anelongate shaft 124, and a rotatable magazine 130.

The syringe 102 may include a plunger 106 that is configured to be atleast partially disposed within the body of the syringe 102 such thatadvancement and retraction of the plunger 106 cause displacement offluid within a reservoir 107 of the syringe 102. The syringe 102 may beconfigured to couple to a proximal end of the frame 110. For example, inthe depicted embodiment, the syringe 102 includes a male Luer lockconnection at its distal end. In some embodiments, the syringe 102 is astandard, commercially available syringe. The syringe 102 may be capableof holding enough fluid to facilitate deployment of multiple medicalcompositions or articles (e.g., medicaments or medical plugs 140) into apatient. For example, in some embodiments, the syringe 102 is capable ofholding at least 3 mL, at least 5 mL, at least 10 mL and/or at least 15mL of fluid. In some embodiments, the syringe 102 is a vacuum locksyringe that allows practitioners to lock the plunger 106 at multiplepositions along the body of the syringe 102. In other embodiments, thesyringe 102 does not include a vacuum lock.

The frame 110 may include a proximal portion 116, a distal portion 118,and a connecting region 122 that is disposed between the proximalportion 116 and the distal portion 118. The proximal portion 116 mayinclude a proximal adaptor 112 and a proximal channel 147. The distalportion 118 may include a distal adaptor 114 and the distal channel 148.

The proximal adaptor 112 may be configured to couple to the distal endof the syringe 102. For example, in the depicted embodiment, theproximal adaptor 112 of the frame 110 is a female Luer connection thatis designed to couple to (e.g., form a fluid-tight connection with) themale Luer connection at the distal end of the syringe 102.

The proximal channel 147 and the distal channel 148 may be configured toprovide portions of a fluid flow path. The fluid flow path may allowfluid to flow sequentially from the reservoir 107 of the syringe 102 tothe proximal channel 147, from the proximal channel 147 to a firstchamber 131 of the rotatable magazine 130, from the chamber 131 of therotatable magazine 130 to the distal channel 148, and from the distalchannel 148 to the patient. The fluid flow path may also allow fluidflow in the reverse direction, i.e., from the distal channel 148,through the chamber 131 of the rotatable magazine 130, through theproximal channel 147 to the reservoir 107 of the syringe 102.

In the depicted embodiment, the proximal channel 147 and the distalchannel 148 are co-linear with one another such that the proximalchannel 147 and the distal channel 148 are fixedly aligned. Theconnecting region 122 that is disposed between the proximal channel 147and the distal channel 148 is not co-linear with the proximal channel147 and the distal channel 148. For example, in the depicted embodiment,the frame 110 is bent into a C-shaped structure such that the connectingregion 122 is offset from the proximal channel 147 and the distalchannel 148.

The frame 110 may be coupled to the elongate shaft 124, which may becylindrical in shape. The elongate shaft 124 may be made from anysuitable material, such as steel. In the depicted embodiment, a firstend of the elongate shaft 124 is attached (e.g., via an adhesive) to theframe 110, while a second end of the elongate shaft 124 (i.e., an end ofthe elongate shaft 124 that is disposed opposite the first end) is notattached to the frame 110. Instead, in the depicted embodiment, theframe 110 includes a cavity 146 for receiving (but not attaching to) thesecond end of the elongate shaft 124. The cavity 146 may be generallyelongate in shape such that the cavity 146 is longer in the elongateddirection than the diameter of the elongate shaft 124. The cavity 146may be elongated to permit deflection of the frame 110 as the rotatablemagazine 130 is rotated relative to the frame 110. In other words, asdescribed below, the cavity 146 may permit deflection of the frame 110as the medical plug delivery device 100 transitions from a configurationin which a first chamber 131 is aligned with both the proximal channel147 and the distal channel 148 to a configuration in which a secondchamber 132 is aligned with both the proximal channel 147 and the distalchannel 148.

In some embodiments, the frame 110 includes one or more notches 142. Theone or more notches 142 may decrease the amount of material at one ormore regions (e.g., at one or more corners) of the frame 110, therebycreating one or more flex points 144 that allow for increasedflexibility of the frame 110. The frame 110 may be made from or compriseany suitable resilient material, such as a plastic.

The frame 110 may also include a distal adaptor 114 that is configuredto couple to an elongate tube, such as an introducer sheath or catheterthat is in fluid communication with an interior of a patient. In someembodiments, the distal adaptor 114 is a simple male Luer connection.Such a simple connection may be formed integrally with the frame 110. Inother embodiments, the distal adaptor 114 includes a male Luer lockconnection that is configured to rotate independent of the remainder ofthe frame 110.

In some embodiments, the frame 110 of the medical plug delivery device100 may include a plurality of caps (not shown). The caps may beconfigured to seal a composition or medical plug within a chamber 131,132, 133, 134, 135 of the rotatable magazine 130. For example, in someembodiments, the frame 110 comprises a first hub with a first pluralityof spokes that extend therefrom. In some embodiments, the frame 110further comprises a second hub with a second plurality of spokes thatextend therefrom. Each spoke of the first and/or second plurality ofspokes may be coupled to a cap. In some embodiments, the caps mayinteract with sloped surfaces 138, 139 of the rotatable magazine 130 toform a seal that prevents a composition or article from escaping from achamber 131, 132, 133, 134, 135. Such caps may interact with the slopedsurfaces 138, 139 in a manner similar to that described below inconnection with protrusions 126, 128. In some embodiments, the hubs arecentered about the elongate shaft 124 of the medical plug deliverydevice 100.

The rotatable magazine 130 may define both (1) a central lumen 136 thatextends through the rotatable magazine 130 and (2) a plurality ofchambers 131, 132, 133, 134, 135 disposed around the central lumen 136.The rotatable magazine 130 may be coupled to the frame 110 via theelongate shaft 124. The elongate shaft 124 may be coupled to the frame110 and extend through the central lumen 136 of the rotatable magazine130, thereby allowing the rotatable magazine 130 to rotate around theelongate shaft 124. In this manner, the rotatable magazine 130 may berotated independent of both the frame 110 and the syringe 102. In someembodiments, the rotatable magazine 130 is substantially cylindrical inshape.

In the depicted embodiment, the rotatable magazine 130 includes a firstchamber 131, a second chamber 132, a third chamber 133, a fourth chamber134, and a fifth chamber 135. Rotatable magazines 130 that include moreor less than five chambers are also within the scope of this disclosure.For example, in other embodiments, the rotatable magazine 130 mayinclude two, three, four, six, seven, eight, nine, or 10 chambers.

Each chamber 131, 132, 133, 134, 135 may be configured to receive acomposition or a medical article. For example, in some embodiments, eachchamber 131, 132, 133, 134, 135 is configured to hold a medicament, suchas a drug in powder form or microspheres. Exemplary medicaments includeantimicrobials, anticoagulants, or any other drug. In some embodiments,the chambers 131, 132, 133, 134, 135 of the medical plug delivery device100 are preloaded with a medicament. In some embodiments, each chamber131, 132, 133, 134, 135 is configured to receive (and/or is preloadedwith) a medical plug 140.

In some embodiments, a cartridge 160 is disposed within each of thechambers 131, 132, 133, 134, 135. The cartridges 160 may be generallyelongate in shape with a hollow interior that defines a primary channel162. Each cartridge 160 may be sized to accommodate a single compositionor medical article (e.g., a medical plug 140). While the chamber 131 andthe cartridge 160 are depicted as separate components, one of ordinaryskill in the art, with the benefit of this disclosure, will recognizethat the chamber 131 and the cartridge 160 may be combined into oneintegrally formed component in some embodiments. In other words, in someembodiments, the entire rotatable magazine 130 is an integrally formedmonolithic part.

In some embodiments, the cartridge 160 fits within the chamber 131 viaan interference fit. In other embodiments, the cartridge 160 is attachedto the chamber 131 via an adhesive. In some embodiments, there is gapbetween at least a portion of the cartridge 160 and a portion of thechamber 131. The gap may be part of a bypass channel 164 that allowsfluid to travel from the proximal end of the distal channel 148, aroundthe exterior surface of the cartridge 160 to the proximal channel 147 ofthe frame 110 without passing through a medical plug 140 (or othercomposition) that is disposed within the primary channel 162 of thecartridge 160. In other words, the bypass channel 164 may provide afluid flow path around the primary channel 162. However, in otherembodiments, no bypass channel is available. Fluid flow in eitherdirection (i.e., proximal to distal or distal to proximal) through thebypass channel 164 is within the scope of this disclosure.

The cartridge 160 may also include a shoulder 150 that is configured torestrict proximal displacement of a medical plug 140 during operation ofthe medical plug delivery device 100. In the depicted embodiment, theshoulder 150 is an annular protrusion that extends inward from thecartridge 160. The shoulder 150 may narrow a passageway (i.e., primarychannel 162) through the cartridge 160. In other words, a proximalportion of the primary channel 162 (e.g., the portion defined by theshoulder 150) may have a smaller diameter than a distal portion of theprimary channel 162. The one or more shoulders 150 may be disposedadjacent a proximal end of the chamber 131. The shoulder(s) 150 may beconfigured to restrict proximal displacement of a medical plug 140during operation of the medical plug delivery device 100. Stateddifferently, the shoulder(s) 150 may be configured to engage a medicalplug 140 and restrict movement of the medical plug 140 proximal of theshoulder 150.

The rotatable magazine 130 may include a ledge 137 adjacent a proximalend of the rotatable magazine 130. The ledge 137 may be designed tocontact the cartridge 160, thereby preventing movement of the cartridge160 past the ledge 137. Other embodiments may lack a ledge.

The rotatable magazine 130 may be disposed directly between the distalportion 118 and the proximal portion 116 of the frame 110. The distalportion 118 and the proximal portion 116 of the frame 110 may togetherprovide a compressive force on the rotatable magazine 130 to form afluid-tight seal between the frame 110 and a chamber of the plurality ofchambers 131, 132, 133, 134, 135. More particularly, in someembodiments, the rotatable magazine 130 includes a proximal slopedsurface 138 that is configured to mate with a corresponding surface(e.g., a first frustoconical protrusion 126) of frame 110. The rotatablemagazine 130 may also include a distal sloped surface 139 that isconfigured to mate with a corresponding surface (e.g., a secondfrustoconical protrusion 128) of the frame 110. (In other embodiments,the position of the frustoconical protrusions and the correspondingsurfaces may be switched such that the rotatable magazine includes thefrustoconical protrusions, and the frame includes the sloped surfaces.)The interactions of the protrusions 126, 128 with the sloped surfaces138, 139 may form fluid-tight seals that place the rotatable magazine130 in fluid communication with the reservoir 107 of the syringe 102. Inthis manner, a fluid-tight seal may be accomplished without the use ofan o-ring. Further disclosure regarding the interaction between thefrustoconical protrusions 126, 128 and the sloped surfaces 138, 139 isdescribed below.

Rotation of the rotatable magazine 130 about the elongate shaft 124 maycause the medical plug delivery device 100 to transition from a firstconfiguration in which a chamber of the plurality of chambers 131, 132,133, 134, 135 is aligned with both the proximal channel 147 and thedistal channel 148 to a second configuration in which a differentchamber of the plurality of chambers 131, 132, 133, 134, 135 is alignedwith both the proximal channel 147 and the distal channel 148.

For example, when the frame 110 and the rotatable magazine 130 arepositioned as shown in FIGS. 1-7 , the first chamber 131 may be in fluidcommunication with the proximal channel 147 and the distal channel 148.As the rotatable magazine 130 is rotated approximately 72 degrees in thedirection indicated in FIGS. 3 and 4 , the second chamber 132 may alignwith the proximal channel 147 and the distal channel 148 of the frame110. As the rotatable magazine 130 is further rotated an additional 72degrees, the third chamber 133 may be aligned with the proximal channel147 and the distal channel 148. In like manner, the rotatable magazine130 may be further rotated in increments of 72 degrees to align thefourth chamber 134 and then the fifth chamber 135 with the proximalchannel 147 and the distal channel 148. When the frame 110 and therotatable magazine 130 are positioned such that none of the chambers131, 132, 133, 134, 135 align with the proximal channel 147 and thedistal channel 148 of the frame 110 (e.g., the chambers 131, 132, 133,134, 135 are disposed at some intermediate position), the rotatablemagazine 130 may not be in fluid communication with the reservoir 107 ofthe syringe 102.

In some embodiments, the rotatable magazine 130 is configured to hold aplurality of medical plugs 140. For example, a medical plug 140 may bedisposed in each of chambers 131, 132, 133, 134, 135 of the rotatablemagazine 130. More particularly, in some embodiments, a medical plug 140may be disposed within a cartridge 160 that is disposed within thechamber 131 of the rotatable magazine 130. In some embodiments, therotatable magazine 130 (or a portion thereof) is substantiallytransparent, thereby allowing the practitioner to visualize wettingand/or ejection of the medical plug 140 as described below. In otherembodiments, the rotatable magazine 130 is opaque. In some embodiments,each medical plug 140 is a different length from other medical plugs 140in the chambers 131, 132, 133, 134, 135 of the medical plug deliverydevice 100. For example, a first medical plug 140 having a first lengthmay be disposed within the first chamber 131, while a second medicalplug (not shown) having a second length (i.e., a length that differsfrom the first length) may be disposed within the second chamber 132. Inthis manner, the medical plug delivery device 100 may be used as amedical plug deployment device for selecting a medical plug 140 ofappropriate length for a particular medical need from among the variouslengths of the medical plugs 140 that are disposed within chambers 131,132, 133, 134, 135 of the rotatable magazine 130. In some embodiments,indicia corresponding to the lengths of the medical plugs 140 may bedisposed on the rotatable magazine 130.

The medical plugs 140 may be of any suitable composition, shape, and/orsize. For example, in some embodiments, the medical plugs 140 include orconsist essentially of a bioabsorbable material. In some embodiments,the bioabsorbable material (or a portion thereof) is derived from animaltissue, such as pig skin or cow skin. In some embodiments, thebioabsorbable material is a collagen-containing material, such as agelatin foam from an animal source. In other or further embodiments, thebioabsorbable material (or a portion thereof) is a synthetic polymer,such as polylactic acid, polyglycolide, or poly(lactic-co-glycolicacid). In some embodiments, the medical plugs 140 include or consist ofa non-bioabsorbable material, such as polyvinyl alcohol or polyvinylacetate. In some embodiments, the medical plugs 140 include a dye. Thedye may facilitate visualization of the medical plugs 140 when themedical plugs 140 are disposed within the rotatable magazine 130. Insome embodiments, the medical plugs 140 may change colors when contactedwith fluid (e.g., water or saline), thereby allowing a practitioner tovisually determine when the medical plugs 140 have been wetted.

The medical plugs 140 may be generally elongate in shape. For example,in some embodiments, the medical plugs 140 are elongate pieces ofmaterial that have been rolled into a substantially cylindrical shape ofbetween 1 mm and 5 mm (e.g., approximately 2 mm) in diameter. Eachmedical plug 140 may have a length that is at least two-fold, at leastfive-fold, and/or at least 10-fold longer than the diameter of themedical plug 140. In some embodiments, each medical plug 140 is between10 mm and 70 mm in length. For example, in some embodiments, one or moremedical plugs 140 are between 10 mm and 50 mm and/or between 10 mm and40 mm (e.g., approximately 20 mm) in length.

The medical plug delivery device 100 may be used to deploy compositionsor medical articles (e.g., medical plugs 140) to a patient. Whileprocesses are described below with particular reference to medical plugs140, a skilled artisan with the benefit of this disclosure willrecognize that analogous processes may be used to deploy other medicalarticles or compositions.

To wet and deploy a first medical plug 140 from the rotatable magazine130, a practitioner may obtain a syringe 102 that includes a plunger106. The practitioner may then attach the syringe 102 to the frame 110(which is coupled to the rotatable magazine 130 via the elongate shaft124). The plunger 106 may be initially disposed such that the plunger106 abuts against the distal tip of the syringe 102. Liquid, such aswater, saline, contrast, any mixture thereof, or any other fluid, maythen be drawn into the medical plug delivery device 100 to wet the firstmedical plug 140 within a first chamber 131 and introduce fluid into thereservoir 107 of the syringe 102. For example, the plunger 106 may beretracted within the body of the syringe 102 while the distal end of theframe 110 is disposed within the liquid. As the plunger 106 is retractedin this manner, fluid may be drawn into the reservoir 107 of the syringe102 via two different pathways. Stated another way, application of anegative pressure within the reservoir 107 may tend to draw fluid intothe reservoir 107 via one or both fluid pathways further describedbelow.

First, as the plunger 106 is retracted, fluid may be drawn into thedistal channel 148, continue through the primary channel 162 (andthereby pass through and wet the medical plug 140), pass through theproximal channel 147, and then enter the reservoir 107 of the syringe102. The shoulder 150 of the cartridge 160 may prevent proximaldisplacement of the medical plug 140 past the shoulder 150, therebyensuring that the medical plug 140 is not inadvertently sucked into thereservoir 107 of the syringe 102. In other words, the shoulder 150 mayengage with the medical plug 140 to inhibit or restrict proximaldisplacement of the medical plug 140. Wetting of the medical plug 140may increase the lubricity of the medical plug 140, thereby facilitatingboth ejection of the medical plug 140 from the medical plug deliverydevice 100 and advancement of the medical plug 140 through a lumen of anelongate tube to an interior portion (e.g., a void) within a patient. Insome embodiments, the medical plug 140 may also swell as it wets, andmay thus partially occlude or disrupt fluid flow through the primarychannel 162.

Second, instead of passing through the medical plug 140, fluid may bedrawn into the distal channel 148, pass through the bypass channel 164,and travel proximally through the proximal channel 147 to enter into thereservoir 107 of the syringe 102. Fluid passing through this pathwaybypasses the medical plug 140.

The two pathways described above may both operate to fill (or partiallyfill) the reservoir 107 of the syringe 102. For example, as the plunger106 is initially retracted, fluid may primarily follow the first pathway(i.e., through the medical plug 140). In some embodiments, as fluidpasses through the medical plug 140, the medical plug 140 is wetted.Wetting and swelling of the medical plug 140 may obstruct further fluidflow through the medical plug 140. As the flow rate of fluid through themedical plug 140 decreases, a greater proportion of the fluid mayinstead pass through the second pathway (i.e., through the bypasschannel 164) to enter into the reservoir 107 of the syringe 102.

Relative flow rates between the two pathways may depend on a variety offactors, such as the composition of the medical plug 140 and thecross-sectional surface areas presented by the primary channel 162 andthe bypass channel 164. For example, in some embodiments, thecross-sectional surface area of the primary channel 162 (where thecross-section is perpendicular to the longitudinal axis of the medicalplug delivery device 100) is greater than the cross-sectional surfacearea of the bypass channel 164. Thus, a relatively large fluidic forcemay be applied to the medical plug 140 (during both retraction andadvancement of the plunger 106) due to its positioning within a channel(i.e., the primary channel 162) having a relatively largecross-sectional surface area in comparison with the cross-sectionalsurface area of the bypass channel 164.

If desired, any air bubbles that were introduced into the medical plugdelivery device 100 as the plunger 106 was retracted may be removed inthe traditional manner (i.e., by orienting the medical plug deliverydevice 100 such that the distal end of the medical plug delivery device100 is pointed upward, tapping the medical plug delivery device 100, andejecting air bubbles by advancing the plunger 106 toward the distal endof the medical plug delivery device 100).

In some circumstances, once both (1) the medical plug 140 has beenwetted, and (2) a sufficient quantity of fluid has entered into thereservoir 107 of the syringe 102, the practitioner may couple the distalend of the frame 110 to an elongate tube, such as an introducer sheathor catheter. The elongate tube may be in fluid communication with a voidinto which the medical plug 140 is to be inserted. For example, thedistal adaptor 114 of the frame 110 may be coupled to a proximal end ofan introducer sheath used in a biopsy procedure as described above. Thepractitioner may then advance the plunger 106 toward the distal end ofthe syringe 102, thereby displacing fluid in a distal direction.

As the fluid is displaced in a distal direction, the fluid may beexpelled from the syringe 102, travel through the proximal channel 147of the frame 110, and exert a distal force on the medical plug 140disposed therein, thereby causing distal displacement and ejection ofthe medical plug 140 from the rotatable magazine 130. The medical plug140 may then continue onward, travelling through the distal channel 148of the frame 110, and through an elongate tube that is coupled to theframe 110 to be placed within a void of the patient. The insertedmedical plug 140 may serve any suitable purpose, such as obstructingfluid flow, inducing blood coagulation, and/or providing a scaffold topromote tissue growth.

In some embodiments or circumstances, instead of retracting the plunger106 to draw fluid into the reservoir 107 of the syringe 102 as describedabove, the syringe 102 may be pre-filled with liquid. The distal end ofthe pre-filled syringe 102 may then be attached to a proximal end of theframe 110. Once the syringe 102 is attached to the proximal end of theframe 110, the plunger 106 may be advanced. Advancement of the plunger106 in this manner may both wet the particular medical plug 140 anddischarge the medical plug 140 from the medical plug delivery device 100into an elongate tube for delivery to a void as described above. Inother words, medical plugs 140 may be hydrated as they are ejected fromthe rotatable magazine 130 instead of being wetted by retraction of theplunger 106.

Once the first medical plug 140 has been deployed from the first chamber131, the medical plug delivery device 100 may be transitioned to adifferent configuration in which the second chamber 132 is in fluidcommunication with the distal channel 148 of the frame 110. Totransition the medical plug delivery device 100 to this configuration,the practitioner may apply a rotational force to the rotatable magazine130, thereby causing the rotatable magazine 130 to be rotationallydisplaced relative to the frame 110. Such rotational displacement of therotatable magazine 130 with respect to the frame 110 may cause atransition from a first configuration in which the first chamber 131 isin fluid communication with the distal channel 148 to a secondconfiguration in which a second chamber 132 is in fluid communicationwith the distal channel 148 of the frame 110.

As the rotatable magazine 130 is initially rotated, the firstfrustoconical protrusion 126 may slide along the sloped surface 138 ofthe rotatable magazine 130, thereby disrupting the fluid-tight sealbetween the first frustoconical protrusion 126 and the sloped surface138. At the same time, the second frustoconical protrusion 128 may slidealong the sloped surface 139 of the rotatable magazine 130, therebydisrupting the fluid-tight seal between the second frustoconicalprotrusion 128 and the sloped surface 139.

In some embodiments, as the rotatable magazine 130 is initially rotatedfrom a position in which the first chamber 131 is aligned with both theproximal channel 147 and the distal channel 148 of the frame 110, theframe 110 may flex, causing an increase in displacement between theproximal portion 116 of the frame 110 and the distal portion 118 of theframe 110. For example, due to the notches 142 in the frame 110, theframe 110 may bend, deflect, and/or flex about one or more flex points144, thereby causing an increase in displacement between the proximalportion 116 of the frame 110 and the distal portion 118 of the frame110. In some embodiments, the frame 110 is designed to flex in a singleplane (i.e., the plane defining the cross-section shown in FIG. 5 ). Insome embodiments, a free end of the proximal portion 116 may bendfurther away from the distal portion 118 than other regions of theproximal portion 116. The cavity 146 of the frame 110 may be designed(e.g., be elongate in shape) to accommodate any displacement of theelongate shaft 124 within the cavity 146 that occurs as the frame 110 isbent while the medical plug delivery device 100 transitions from a firstconfiguration in which the first chamber 131 is aligned with both theproximal channel 147 and the distal channel 148 to a secondconfiguration in which the second chamber 132 is aligned with both theproximal channel 147 and the distal channel 148. Stated differently, thecavity 146 may provide clearance for the elongate shaft 124, therebyallowing the frame 110 to flex.

As the rotatable magazine 130 is further rotated, the firstfrustoconical protrusion 126 may approach a proximal opening to thesecond chamber 132, and the second frustoconical protrusion 128 mayapproach a distal opening to the second chamber 132. As the firstfrustoconical protrusion 126 and the second frustoconical protrusion 128approach the second chamber 132, the frame 110 may exert a compressiveforce on the rotatable magazine 130 due to the resiliency of the frame110. Stated differently, the frame 110 may be biased to provide acompressive force when in a flexed state. Such a compressive force maycause the first frustoconical protrusion 126 to slide along the slopedsurface 138 adjacent the second chamber 132, and the secondfrustoconical protrusion 128 to slide along the sloped surface 139 suchthat the frustoconical protrusions 126, 128 are guided to a position inwhich the second chamber 132 is aligned with the proximal channel 147and the distal channel 148 of the frame 110. When aligned in thismanner, the frustoconical protrusions 126, 128 and the sloped surfaces138, 139 may form liquid-tight seals. In other words, the compressiveforce provided by the frame 110 may facilitate seating of thefrustoconical protrusions 126, 128 into the corresponding slopedsurfaces 138, 139.

In some embodiments, the compressive force may cause the frustoconicalprotrusions 126, 128 to snap into the sloped surfaces 138, 139, therebyproviding the practitioner with tactile and/or audible feedback that oneof the chambers 131, 132, 133, 134, 135 is properly aligned with theproximal channel 147 and the distal channel 148 of the frame 110. Insome embodiments, the frame 110 and/or the rotatable magazine 130include indicia that allow the practitioner to visually determinewhether the proximal channel 147 and the distal channel 148 are alignedwith a particular chamber 131, 132, 133, 134, 135 of the rotatablemagazine 130.

Once the frame 110 and the rotatable magazine 130 are positioned suchthat the second chamber 132 of the rotatable magazine 130 is alignedwith both the proximal channel 147 and the distal channel 148, thepractitioner may wet and deploy a second medical plug 140 from thesecond chamber 132 in a manner analogous to that described above inconnection with the first medical plug 140 that was disposed within thefirst chamber 131. Once the second medical plug 140 has been deployed,the rotatable magazine 130 may be further rotated relative to the frame110 to enable wetting and deployment of a third medical plug 140 fromthe third chamber 133. Medical plugs within the fourth chamber 134 andthe fifth chamber 135 may be wetted and deployed by analogous methods. Askilled artisan will recognize that rotatable magazines 130 that includeany number of medical plugs 140 are contemplated and within the scope ofthis disclosure.

In some embodiments, the rotatable magazine 130 may be rotated whileusing only a single hand. For example, when the syringe 102 is heldbetween the palm of the hand and the middle, ring, and/or pinky fingers,the rotatable magazine 130 may be rotated between the thumb and indexfinger of the same hand. In some embodiments, such as the embodimentdepicted in FIGS. 1-7 , the medical plug delivery device 100 isconfigured for ambidextrous use. In other words, the medical plugdelivery device 100 may be principally or exclusively operated usingeither the left hand or the right hand.

In the depicted embodiment, the medical plug delivery device 100 isconfigured to rotate in either a counterclockwise or a clockwisedirection (as viewed from the distal end of the medical plug deliverydevice 100). In other embodiments, the medical plug delivery device 100is configured to rotate around the elongate shaft 124 in only a singledirection. Further, in some embodiments, the medical plug deliverydevice 100 may include a stop (e.g., an obstruction) (not shown) thatprevents more than one rotation of the rotatable magazine 130 about theelongate shaft 124. Embodiments that both (1) permit only unidirectionalrotation of the rotatable magazine 130 and (2) include a stop such asthe stop described above may prevent a practitioner from unintentionallyreturning to a chamber 131, 132, 133, 134, 135 from which a compositionor medical article has already been deployed.

The medical plug delivery device 100 may be manufactured via anysuitable method. For example, in some embodiments, a method ofmanufacturing the medical plug delivery device 100 comprises placing therotatable magazine 130 between the proximal portion 116 and the distalportion 118 of the frame 110. Adhesive may then be placed along theedges of a cavity in the distal portion 118 of the frame 110. Theelongate shaft 124 may then be inserted through the (proximal) cavity146, through the central lumen 136 of the rotatable magazine 130, andinto the (distal) cavity such that the adhesive binds to a distal end ofthe elongate shaft 124. In this manner, the distal end of the elongateshaft 124 (but not the proximal end) is attached to the frame 110. Insome embodiments, manufacture of the rotatable magazine 130 involvesinsertion of a plurality of cartridges 160 into the chambers 131, 132,133, 134, 135 of the rotatable magazine 130. Each of the cartridges 160may be attached to one of the chambers 131, 132, 133, 134, 135 via anadhesive.

FIGS. 8-14 depict a medical plug delivery device 200 (or portionsthereof) for delivering compositions and/or medical articles to apatient. More particularly, FIG. 8 provides a perspective view of themedical plug delivery device 200. FIG. 9 provides an alternativeperspective view of the medical plug delivery device 200, with a syringe202 removed for clarity. FIG. 10 is a cross-sectional view of a portionof the medical plug delivery device of FIGS. 8-9 . FIG. 11 is anexploded view of a portion of the medical plug delivery device. FIG. 12is another exploded view of a portion of the medical plug deliverydevice. FIG. 13 is a proximal end view of the medical plug deliverydevice with the selector in a first position. FIG. 14 is a proximal endview of the medical plug delivery device with the selector in a secondposition.

As depicted in FIGS. 8-14 , the medical plug delivery device 200 mayinclude a fluid delivery device such as the syringe 202, a selector 210,a guide 250, and a magazine 230.

The syringe 202 may include a plunger 206 that is configured to be atleast partially disposed within the body of the syringe 202 such thatadvancement and retraction of the plunger 206 causes displacement offluid within a reservoir 207 of the syringe 202. The syringe 202 may beconfigured to couple to a proximal end of the selector 210. For example,in the depicted embodiment, the syringe 202 includes a male Luer lockconnector 208 at its distal end. In some embodiments, the syringe 202 isa standard, commercially available syringe. The syringe 202 may becapable of holding enough fluid to facilitate deployment of multiplemedical compositions or articles (e.g., medicaments or medical plugs240) into a patient. For example, in some embodiments, the syringe 202is capable of holding at least 3 mL, at least 5 mL, at least 10 mLand/or at least 15 mL of fluid. In some embodiments, the syringe 202 maybe a vacuum lock syringe that allows practitioners to lock the plunger206 at multiple positions along the body of the syringe 202. In otherembodiments, the syringe 202 does not include a vacuum lock.

The selector 210 may include a proximal portion 216 and a distal surface218. The proximal portion 216 may include a proximal adaptor 212, aproximal channel 247 and a rotation tab 228. The distal surface 218 mayinclude a distal end 211 of the channel 247, an elastic member recess213, and an orifice or through hole 215.

The proximal adaptor 212 may be configured to couple to the distal endof the syringe 202. For example, in the depicted embodiment, theproximal adaptor 212 of the selector 210 is a female Luer connectionthat is designed to couple to (e.g., form a fluid-tight connection with)the male Luer connection at the distal end of the syringe 202.

The proximal channel 247 and a distal channel 248 may be configured toprovide portions of a fluid flow path. The fluid flow path may allowfluid to flow sequentially from the reservoir 207 of the syringe 202 tothe proximal channel 247, from the proximal channel 247 to a firstchamber 231 of the magazine 230, from the chamber 231 of the magazine230 to the distal channel 248, and from the distal channel 248 to thepatient. The fluid flow path may also allow fluid flow in the reversedirection, i.e., from the distal channel 248, through the chamber 231 ofthe magazine 230, through the proximal channel 247 to the reservoir 207of the syringe 202.

In the depicted embodiment, the proximal channel 247 and the distalchannel 248 are not co-linear with one another, such that the proximalchannel 247 may be radially offset from the longitudinal axis of themedical plug delivery device 200, and the distal channel 248 may becentrally aligned with the longitudinal axis of the medical plugdelivery device 200. In some embodiments, the longitudinal axis of themedical plug delivery device 200 may not pass through the center ofgravity. Rather, the center of gravity may be radially displaced.

The selector 210 may include a rotation tab 228 configured to allow thepractitioner to rotate the selector 210 relative to the magazine 230.The rotation tab 228 may be radially offset and extend proximally fromthe proximal portion 216 of the selector 210. The rotation tab 228 maybe positioned approximately 180 degrees from the proximal channel 247.The rotation tab 228 may be configured to allow the practitioner toapply a rotational force to the rotation tab 228 with a finger or thumbor to grip the rotation tab 228 between a finger and thumb to apply arotational force.

The elastic member recess 213 of the distal surface 218 of the selector210 may be configured to retain an elastic member 217 and a detent 219.The elastic member recess 213 may be radially disposed toward the outerperimeter of the distal surface 218 and approximately 180 degrees fromthe distal end 211 of the proximal channel 247. The elastic member 217may be any type of elastically deformable member, such as a coiledspring, leaf spring, leaf arm, etc. The elastic member 217 may beconfigured to be compressed or biased and to provide a directed force tothe detent 219. The detent 219 may engage the elastic member 217 and maybe at least partially retained by the elastic member recess 213. Thedistal end of the detent 219 may include a square side 221 and a slopedside 222 that is opposite of the square side 221.

In some embodiments, the distal surface 218 of the selector 210 may facea proximal surface 238 of the magazine 230. The proximal surface 238 mayinclude an annular recess 239 near the perimeter of the proximal surface238. The annular recess 239 may be configured for retention of aperimeter sealing member 241. The perimeter sealing member 241 may be ano-ring or other similar type of sealing device. The proximal surface 238may also include recesses 270, 271, 272, 273, 274, 275 disposed near theannular recess 239. Each of the recesses 270, 271, 272, 273, 274, 275may be configured to define a position where the proximal channel 247 iseither not in alignment with proximal ends 242 of the chambers 231, 232,233, 234, 235 or in alignment with the proximal ends 242 of the chambers231, 232, 233, 234, 235. The number of recesses 270, 271, 272, 273, 274,275 may equal the number of chambers 231, 232, 233, 234, 235 plus oneadditional recess 270, 271, 272, 273, 274, 275. For example, in oneembodiment, if the number of chambers 231, 232, 233, 234, 235 is fivethen the number of recesses 270, 271, 272, 273, 274, 275 is six. Therecesses 270, 271, 272, 273, 274, 275 may be configured to interfacewith the detent 219. The recesses 270, 271, 272, 273, 274, 275 may beconfigured with a sloped side and a square face (or otherwise non-slopedside) to correspond to the sloped face and square side (or non-slopedside) of the detent 219. The interface between the detent 219 and therecesses 270, 271, 272, 273, 274, 275 may define rotation of theselector 210 in only one direction. For example, the square side of thedetent 219 may face the square side of the recess 270, 271, 272, 273,274, 275 and prevent rotation of the selector 210 when the two squaresides are forced against one another. Rotation is possible when thesloped side of the detent 219 faces the sloped side of the recess 270,271, 272, 273, 274, 275 and a force is applied against the two slopedsides.

The proximal surface 238 further defines a cavity 243. The cavity 243may be positioned between two proximal ends 242 of the chambers 231,232, 233, 234, 235. For example, in one embodiment the cavity 243 may bepositioned between the first chamber 231 and a fifth chamber 235. Thecavity 243 may be “T” shaped with the leg of the “T” directed to theperimeter of the proximal surface 218. In some embodiments, the distalsurface 218 may comprise the recess 270, 271, 272, 273, 274, 275, andthe proximal surface 238 of the magazine 230 may comprise the elasticmember recess 213.

A gap 226 may be defined between the distal surface 218 of the selector210 and the proximal surface 238 of magazine 230. The gap 226 may besealed on its perimeter by the perimeter sealing member 241 and near itscenter by an elongate member o-ring 244 surrounding the elongate member224. A spacer disc 245 surrounding the elongate member 224 may beconfigured to prevent the proximal surface 238 and the distal surface218 from touching, thus providing the gap 226. A distal end o-ring 246may be positioned at the distal end 211 of the proximal channel 247. Thedistal end o-ring 246 may be configured to direct fluid flow either fromthe proximal channel 247 to a chamber 231, 232, 233, 234, 235 or from achamber 231, 232, 233, 234, 235 to the proximal channel 247 when theproximal channel 247 is in alignment with the chamber 231, 232, 233,234, 235. Therefore, fluid is selectively directed into or from achamber 231, 232, 233, 234, 235. Alternatively, the proximal channel 247may be in alignment with the cavity 243. In this position, the distalend o-ring 246 does not prevent fluid from flowing into the gap 226.Rather, fluid is permitted to flow either from the proximal channel 247,through the cavity 243, into the gap 226, and simultaneously into thechambers 231, 232, 233, 234, 235, or from the chambers 231, 232, 233,234, 235, into the gap 226, through the cavity 243 and into the proximalchannel 247. In other words, the gap 226 is configured to allow forsimultaneous fluid flow to all of the chambers 231, 232, 233, 234, 235from the proximal channel 247 or to allow for simultaneous flow from allof the chambers 231, 232, 233, 234, 235 to the proximal channel 247.

The guide 250 may include the distal channel 248 and guide channels 249.The proximal ends of the guide channels 249 may align with the chambers231, 232, 233, 234, 235. The guide channels 249 may merge into thedistal channel 248. The guide channels 249 are configured either toguide or direct fluid flow into the chambers 231, 232, 233, 234, 235from the distal channel 248 or to direct or guide fluid flow and/or themedical plug 240 into the distal channel 248. The guide 250 may begenerally cone shaped and be configured to be attached to the distal endof the magazine 230. The distal channel 248 may include a distal adaptor214 that is configured to couple to an elongate tube, such as anintroducer sheath or catheter that is in fluid communication with aninterior of a patient. In some embodiments, the distal adaptor 214 is asimple male Luer connection. Such a simple connection may be formedintegrally with the guide 250. In other embodiments, the distal adaptor214 includes a male Luer lock connection that is configured to rotateindependent of the remainder of the guide 250.

The magazine 230 may define both a central lumen 236 that extendsthrough the magazine 230 and a plurality of chambers 231, 232, 233, 234,235 disposed around the central lumen 236. A shouldered cylinder 220 maybe partially disposed within the central lumen 236. The shoulderedcylinder 220 may include a cylinder body 265 with a frustoconical shapeddistal end 229 and a proximally directed shoulder 227. The magazine 230may be fixedly and sealingly coupled to the guide 250 with a guidesealing member 252 positioned between the magazine 230 and the guide250. The guide sealing member 252 may be an o-ring or other similar typeof sealing device. Alternatively, the guide sealing member 252 may beexcluded from the assembly.

The selector 210 may rotatably coupled to the magazine 230 (or themagazine 230 is rotatably coupled to the selector 210) via the elongatemember 224. The body 265 of shouldered cylinder 220 may be disposedwithin the central lumen 236 with the shoulder 227 directed toward thedistal end of the magazine 230. The elongate member 224 may extendthrough a rotation washer 223, through the through hole 216 of theselector 210, through the spacer disc 245, through the elongate membero-ring 244 and into the body 265 of shouldered cylinder 220. Theelongate member 224 may be threadably coupled to the shouldered cylinder220 such that as the elongate member 224 is threaded into the shoulderedcylinder 220, the shoulder 227 contacts the distal face of the magazine230. The head of the elongate member 224 and the shoulder 227 direct acompressive force to the selector 210 and the magazine 230 such that thedistal surface 218 approximates the proximal surface 238 to provide thegap 226. The perimeter sealing member 241 may be compressed between theselector 210 and the magazine 230 to provide a fluid-tight seal. Theselector 210 may be configured to rotate around the elongate member 224relative to the magazine 230 while maintaining a fluid seal to theexterior of the medical plug delivery device 200. In some embodiments,the magazine 230 is substantially cylindrical in shape.

In the depicted embodiment, the magazine 230 includes a first chamber231, a second chamber 232, a third chamber 233, a fourth chamber 234,and a fifth chamber 235. Magazines 230 that include more or less thanfive chambers are also within the scope of this disclosure. For example,in other embodiments, the magazine 230 may include two, three, four,six, seven, eight, nine, or 10 chambers.

Each chamber 231, 232, 233, 234, 235 may be configured to receive acomposition or a medical article. For example, in some embodiments, eachchamber 231, 232, 233, 234, 235 is configured to hold a medicament, suchas a drug in powder form or microspheres. Exemplary medicaments includeantimicrobials, anticoagulants, or any other drug. In some embodiments,the chambers 231, 232, 233, 234, 235 of the medical plug delivery device200 are preloaded with a medicament. In some embodiments, each chamber231, 232, 233, 234, 235 is configured to receive (and/or is preloadedwith) a medical plug 240.

In some embodiments, a cartridge 260 is disposed within each of thechambers 231, 232, 233, 234, 235. The cartridges 260 may be generallyelongate in shape with a hollow interior that defines a primary channel262. Each cartridge 260 may be sized to accommodate a single compositionor medical article (e.g., a medical plug 240). While the chamber 231 andthe cartridge 260 are depicted as separate components, one of ordinaryskill in the art, with the benefit of this disclosure, will recognizethat the chamber 231 and the cartridge 260 may be combined into oneintegrally formed component in some embodiments. In other words, in someembodiments, the entire magazine 230 is an integrally formed monolithicpart.

In some embodiments, the cartridge 260 fits within the chamber 231 viaan interference fit. In other embodiments, the cartridge 260 is attachedto the chamber 231 via an adhesive. In some embodiments, there is gapbetween at least a portion of the cartridge 260 and a portion of thechamber 231. The gap may be part of a bypass channel 264 that allowsfluid to travel from the proximal end of the distal channel 248, aroundthe exterior surface of the cartridge 260 to the proximal channel 247 ofthe selector 210 without passing through a medical plug 240 (or othercomposition) that is disposed within a primary channel 262 of thecartridge 260. In other words, the bypass channel 264 may provide afluid flow path around the primary channel 262. However, in otherembodiments, no bypass channel is available. Fluid flow in eitherdirection (i.e., proximal to distal or distal to proximal) through thebypass channel 264 is within the scope of this disclosure.

The cartridge 260 may also include a shoulder 251 that is configured torestrict proximal displacement of a medical plug 240 during operation ofthe medical plug delivery device 200. In the depicted embodiment, theshoulder 251 is an annular protrusion that extends inward from thecartridge 260. The shoulder 251 may narrow a passageway (i.e., primarychannel 262) through the cartridge 260. In other words, a proximalportion of the primary channel 262 (e.g., the portion defined by theshoulder 251) may have a smaller diameter than a distal portion of theprimary channel 262. One or more shoulders 251 may be disposed adjacenta proximal end of the chamber 231. The shoulder(s) 251 may be configuredto restrict proximal displacement of a medical plug 240 during operationof the medical plug delivery device 200. Stated differently, theshoulder(s) 251 may be configured to engage a medical plug 240 andrestrict movement of the medical plug 240 proximal of the shoulder 251.

The magazine 230 may include a ledge 237 adjacent a proximal end of themagazine 230. The ledge 237 may be designed to contact the cartridge260, thereby preventing movement of the cartridge 260 past the ledge237. Other embodiments may lack a ledge.

Rotation of the selector 210 about the elongate member 224 may cause themedical plug delivery device 200 to transition from a firstconfiguration in which a chamber of the plurality of chambers 231, 232,233, 234, 235 is not aligned with the proximal channel 247 to a secondconfiguration in which a chamber of the plurality of chambers 231, 232,233, 234, 235 is aligned with the proximal channel 247.

For example, when the selector 210 and the magazine 230 are positionedas shown in FIG. 13 , the proximal channel 247 may be in fluidcommunication with the gap 226 through the cavity 243. As the selector210 is rotated approximately 36 degrees in the direction indicated inFIG. 14 , the detent 219 may disengage from the recess 270 and thenengage with the recess 271. The first chamber 231 may align with and bein fluid communication with the proximal channel 247. As the selector210 is rotated approximately 72 degrees, the detent 219 may disengagefrom the recess 271 and then engage with the recess 272. The secondchamber 232 may align with and be in fluid communication with theproximal channel 247. As the selector 210 is rotated anotherapproximately 72 degrees, the detent 219 may disengage from the recess272 and then engage with the recess 273. The third chamber 233 may alignwith and be in fluid communication with the proximal channel 247. Inlike manner, the magazine 230 may be further rotated in increments of 72degrees to align the fourth chamber 234 and then the fifth chamber 235with the proximal channel 247.

In some embodiments, the force of the elastic member 217 on the detent219 may cause the detent 219 to snap into the recesses 271, 272, 273,274, 275 as the selector 210 is being rotated, thereby providing thepractitioner with tactile and/or audible feedback that one of thechambers 231, 232, 233, 234, 235 is properly aligned with the proximalchannel 247 and the distal surface of the selector 210. In someembodiments, the selector 210 and/or the magazine 230 include indiciathat allow the practitioner to visually determine whether the proximalchannel 247 is aligned with a particular chamber 231, 232, 233, 234, 235of the magazine 230.

In some embodiments, the magazine 230 is configured to hold a pluralityof medical plugs 240. For example, a medical plug 240 may be disposed ineach of the chambers 231, 232, 233, 234, 235 of the magazine 230. Moreparticularly, in some embodiments, a medical plug 240 may be disposedwithin a cartridge 260 that is disposed within the chamber 231 of themagazine 230. In some embodiments, the magazine 230 (or a portionthereof) is substantially transparent, thereby allowing the practitionerto visualize wetting and/or ejection of the medical plug 240 asdescribed below. In other embodiments, the magazine 230 is opaque. Insome embodiments, each medical plug 240 is a different length from theother medical plugs 240 in the chambers 231, 232, 233, 234, 235 of themedical plug delivery device 200. For example, a first medical plug 240having a first length may be disposed within the first chamber 231,while a second medical plug (not shown) having a second length (i.e., alength that differs from the first length) may be disposed within thesecond chamber 232. In this manner, the medical plug delivery device 200may be used as a medical plug deployment device for selecting a medicalplug 240 of appropriate length for a particular medical need from amongthe various lengths of the medical plugs 240 that are disposed withinthe chambers 231, 232, 233, 234, 235 of the magazine 230. In someembodiments, indicia corresponding to the lengths of the medical plugs240 may be disposed on the magazine 230.

The medical plugs 240 may be of any suitable composition, shape, and/orsize. For example, in some embodiments, the medical plugs 240 include orconsist essentially of a bioabsorbable material. In some embodiments,the bioabsorbable material (or a portion thereof) is derived from animaltissue, such as pig skin or cow skin. In some embodiments, thebioabsorbable material is a collagen-containing material, such as agelatin foam from an animal source. In other or further embodiments, thebioabsorbable material (or a portion thereof) is a synthetic polymer,such as polylactic acid, polyglycolide, or poly(lactic-co-glycolicacid). In some embodiments, the medical plugs 240 include or consist ofa non-bioabsorbable material, such as polyvinyl alcohol or polyvinylacetate. In some embodiments, the medical plugs 140 include a dye. Thedye may facilitate visualization of the medical plugs 140 when themedical plugs 240 are disposed within the magazine 230. In someembodiments, the medical plugs 240 may change colors when contacted withfluid (e.g., water or saline), thereby allowing a practitioner tovisually determine when the medical plugs 140 have been wetted.

The medical plugs 240 may be generally elongate in shape. For example,in some embodiments, the medical plugs 240 are elongate pieces ofmaterial that have been rolled into a substantially cylindrical shape ofbetween 1 mm and 5 mm (e.g., approximately 2 mm) in diameter. Eachmedical plug 240 may have a length that is at least two-fold, at leastfive-fold, and/or at least 10-fold longer than the diameter of themedical plug 240. In some embodiments, each medical plug 240 is between10 mm and 70 mm in length. For example, in some embodiments, one or moremedical plugs 240 are between 10 mm and 50 mm and/or between 10 mm and40 mm (e.g., approximately 20 mm) in length.

The medical plug delivery device 200 may be used to deploy compositionsor medical articles (e.g., medical plugs 240) to a patient. Whileprocesses are described below with particular reference to medical plugs240, a skilled artisan with the benefit of this disclosure willrecognize that analogous processes may be used to deploy other medicalarticles or compositions.

To wet and deploy a first medical plug 240 from the magazine 230, apractitioner may obtain a syringe 202 that includes a plunger 206. Thepractitioner may then attach the syringe 202 to the selector 210 (whichis coupled to the magazine 230 via the elongate member 224). The plunger206 may be initially disposed such that the plunger 206 abuts againstthe distal tip of the syringe 202. Liquid, such as water, saline,contrast, any mixture thereof, or any other fluid, may then be drawninto the medical plug delivery device 200 to wet the medical plugs 240within the chambers 231, 232, 233, 234, 235 simultaneously and introducefluid into the reservoir 207 of the syringe 202. For example, theplunger 206 may be retracted within the body of the syringe 202 whilethe distal channel 248 is disposed within the liquid. As the plunger 206is retracted in this manner, fluid may be drawn into the reservoir 207of the syringe 202 via two different pathways. Stated another way,application of a negative pressure within the reservoir 207 may tend todraw fluid into the reservoir 207 via one or both fluid pathways furtherdescribed below.

First, as the plunger 206 is retracted, fluid may be drawn into thedistal channel 248, simultaneously continue through the primary channels262 of cartridges 260 (and thereby pass through and wet the medicalplugs 240), pass through the gap 226, pass through the proximal channel247, and then enter the reservoir 207 of the syringe 202. The shoulder251 of the cartridge 260 may prevent proximal displacement of themedical plug 240 past the shoulder 251, thereby ensuring that themedical plug 240 is not inadvertently sucked into the reservoir 207 ofthe syringe 202. In other words, the shoulder 251 may engage with themedical plug 240 to inhibit or restrict proximal displacement of themedical plug 240. Wetting of the medical plug 240 may increase thelubricity of the medical plug 240, thereby facilitating both ejection ofthe medical plug 240 from the medical plug delivery device 200 andadvancement of the medical plug 240 through a lumen of an elongate tubeto an interior portion (e.g., a void) within a patient. In someembodiments, the medical plug 240 may also swell as it wets, and maythus partially occlude or disrupt fluid flow through the primary channel262.

Second, instead of passing through the medical plug 240, fluid may bedrawn into the distal channel 248, simultaneously pass through thebypass channels 264 of cartridges 260, travel proximally through the gap226, and travel through the proximal channel 247 to enter into thereservoir 207 of the syringe 202. Fluid passing through this pathwaybypasses the medical plug 240.

The two pathways described above may both operate to fill (or partiallyfill) the reservoir 207 of the syringe 202. For example, as the plunger206 is initially retracted, fluid may primarily follow the first pathway(i.e., through the medical plug 240). In some embodiments, as fluidpasses through the medical plug 240, the medical plug 240 is wetted.Wetting and swelling of the medical plug 240 may obstruct further fluidflow through the medical plug 240. As the flow rate of fluid through themedical plug 240 decreases, a greater proportion of the fluid mayinstead pass through the second pathway (i.e., through the bypasschannel 264) to enter into the reservoir 207 of the syringe 202.

Relative flow rates between the two pathways may depend on a variety offactors, such as the composition of the medical plug 240 and thecross-sectional surface areas presented by the primary channel 262 andthe bypass channel 264. For example, in some embodiments, thecross-sectional surface area of the primary channel 262 (where thecross-section is perpendicular to the longitudinal axis of the medicalplug delivery device 200) is greater than the cross-sectional surfacearea of the bypass channel 264. Thus, a relatively large fluidic forcemay be applied to the medical plug 240 (during both retraction andadvancement of the plunger 206) due to its positioning within a channel(i.e., the primary channel 262) having a relatively largecross-sectional surface area in comparison with the cross-sectionalsurface area of the bypass channel 264.

If desired, any air bubbles that were introduced into the medical plugdelivery device 200 as the plunger 206 was retracted may be removed inthe traditional manner (i.e., by orienting the medical plug deliverydevice 200 such that the distal end of the medical plug delivery device200 is pointed upward, tapping the medical plug delivery device 200, andejecting air bubbles by advancing the plunger 206 toward the distal endof the medical plug delivery device 200).

In some circumstances, once both the medical plug 240 has been wettedand a sufficient quantity of fluid has entered into the reservoir 207 ofthe syringe 202, the practitioner may couple the distal channel 248 toan elongate tube, such as an introducer sheath or catheter. The elongatetube may be in fluid communication with a void into which the medicalplug 240 is to be inserted. For example, the distal adaptor 214 may becoupled to a proximal end of an introducer sheath used in a biopsyprocedure as described above. The practitioner may rotate the selector210 one position to a first ejection position. The rotation to the firstejection position may be confirmed by a tactile and an audible feedback.The practitioner may then advance the plunger 206 toward the distal endof the syringe 202, thereby displacing fluid in a distal direction.

As the fluid is displaced in a distal direction, the fluid may beexpelled from the syringe 202, travel through the proximal channel 247of the selector 210 to the chamber 231, and exert a distal force on themedical plug 240 disposed therein, thereby causing distal displacementand ejection of the medical plug 240 from the magazine 230. The medicalplug 240 may then continue onward, travelling through the guide channel249, the distal channel 248, and an elongate tube that is coupled to thedistal channel 248 to be placed within a void of the patient. Theinserted medical plug 240 may serve any suitable purpose, such asobstructing fluid flow, inducing blood coagulation, and/or providing ascaffold to promote tissue growth.

In some embodiments or circumstances, instead of retracting the plunger206 to draw fluid into the reservoir 207 of the syringe 202 as describedabove, the syringe 202 may be pre-filled with liquid. The distal end ofthe pre-filled syringe 202 may then be attached to a proximal end of theselector 210. Once the syringe 202 is attached to the proximal channel247, the plunger 206 may be advanced. Advancement of the plunger 206 inthis manner may both wet the particular medical plug 240 and dischargethe medical plug 240 from the medical plug delivery device 200 into anelongate tube for delivery to a void as described above. In other words,the medical plugs 240 may be hydrated as they are ejected from themagazine 230 instead of being wetted by retraction of the plunger 206.

Once the first medical plug 240 has been deployed from the first chamber231, the medical plug delivery device 200 may be transitioned to adifferent configuration in which the second chamber 232 is in fluidcommunication with the proximal channel 247 of the selector 210. Totransition the medical plug delivery device 200 to this configuration,the practitioner may apply a rotational force to the selector 210,thereby causing the selector 210 to be rotationally displaced relativeto magazine 230. Such rotational displacement of the selector 210 withrespect to the magazine 230 may cause a transition from a first ejectionconfiguration in which the first chamber 231 is in fluid communicationwith the distal channel 248 to a second ejection configuration in whichthe second chamber 232 is in fluid communication with the distal channel248 of the selector 210.

Once the selector 210 and the magazine 230 are positioned such that thesecond chamber 232 of the magazine 230 is aligned with the proximalchannel 247, the practitioner may wet and deploy a second medical plug240 from the second chamber 232 in a manner analogous to that describedabove in connection with the first medical plug 240 that was disposedwithin the first chamber 231. Once the second medical plug 240 has beendeployed, the selector 210 may be further rotated relative to themagazine 230 to enable wetting and deployment of a third medical plug240 from the third chamber 233. Medical plugs within the fourth chamber234 and the fifth chamber 235 may be wetted and deployed by analogousmethods. A skilled artisan will recognize that magazines 230 thatinclude any number of medical plugs 240 are contemplated and within thescope of this disclosure.

In the depicted embodiment, the medical plug delivery device 200 isconfigured to rotate in a counterclockwise direction (as viewed from theproximal end of the medical plug delivery device 200). The medical plugdelivery device 200 is configured to rotate around the elongate member224 in only a single direction. Rotation in a clockwise direction may beprevented by the interface of the square face of the recesses 270, 271,272, 273, 274, 275 with the square face of the detent 219. Further, insome embodiments, the medical plug delivery device 200 may include astop (e.g., an obstruction) (not shown) that prevents more than onerotation of the selector 210 about the elongate member 224. Embodimentsthat both permit only unidirectional rotation of the selector 210 andinclude a stop such as the stop described above may prevent apractitioner from unintentionally returning to a chamber 231, 232, 233,234, 235 from which a composition or medical article has already beendeployed.

The medical plug delivery device 200 may be manufactured via anysuitable method. For example, in some embodiments, a method ofmanufacturing the medical plug delivery device 200 comprises insertionof a plurality of cartridges 260 into the chambers 231, 232, 233, 234,235 of the magazine 230. Each of the cartridges 260 may be attached toone of the chambers 231, 232, 233, 234, 235 via an adhesive. In someembodiments the shouldered cylinder 220 is disposed in the central lumen236 of the magazine 230. The guide 250 may be attached to the magazine230. The elongate member 224 may then be inserted through the selector210, through the central lumen 236 of the magazine 230, and into theshouldered cylinder 220 such that the elongate member 224 engagesthreads in the shouldered cylinder 220 and the selector 210 is rotatablycoupled to the magazine 230.

FIG. 15 provides an annotated photograph of a medical device 300 fordelivering a plurality of plugs to one or more interior regions of apatient. As depicted in FIG. 15 , the medical device 300 may include aplunger 310, a syringe body 320, and a plug holder 330.

The plunger 310 may include a handle 312 adjacent the proximal end ofthe plunger 310, and a seal 314 adjacent the distal end of the plunger310. The plunger 310 may be configured to be at least partially disposedwithin the syringe body 320 such that advancement and retraction of theplunger 310 causes displacement of fluid within a reservoir 326 of thesyringe body 320. The syringe body 320 may be configured to couple to aproximal end of the plug holder 330. For example, in the depictedembodiment, the syringe body 320 includes a male Luer connection at itsdistal end 324. The plunger 310 and the syringe body 320 may becomponents of standard, commercially available syringes. The syringebody 320 may be capable of holding enough fluid to facilitate deploymentof multiple plugs into a patient. For example, in some embodiments, thesyringe body 320 is capable of holding at least 5 mL or at least 10 mLof fluid.

The plug holder 330 may be configured to couple to the distal end 324 ofthe syringe body 320. The plug holder 330 is shown in further detail inFIGS. 16-23 . More particularly, FIG. 16 provides a front view of theplug holder 330. FIG. 17 provides a cross-sectional front view of theplug holder 330, taken through plane 17-17 of FIG. 18 . FIGS. 18 and 19provide top (FIG. 18 ) and bottom (FIG. 19 ) views of the plug holder330. FIG. 20 provides a side view of the plug holder 330. FIG. 21 is across-sectional perspective view of a resilient adaptor 360 of the plugholder 330 taken through a plane in the position indicated by plane17-17 of FIG. 18 . FIG. 22 is a cross-sectional perspective view of aplug magazine 350, a plug 340, and plug cartridges 390 of the plugholder 330 taken through a plane in the position indicated by plane17-17 of FIG. 18 . FIG. 23 is a cross-sectional view of the plugmagazine 350 through line 23-23 of FIG. 17 .

As shown in FIGS. 16-23 , the plug holder 330 may include the plugmagazine 350 and a resilient adaptor 360. In the depicted embodiment,the plug magazine 350 is a solid rectangular prism with a plurality ofparallels cavities 351 that extend from one side of the plug magazine350 to an opposite side of the plug magazine 350. The plug magazine 350may be configured to hold a plurality of plugs 340. For example, a plug340 may be disposed in each of the cavities 351 of the plug magazine350. In some embodiments, the plug holder 330 (or a portion thereof) issubstantially transparent, thereby allowing the practitioner to view thewetting and ejection of the plug 340 as described below. In otherembodiments, the plug holder 330 is opaque. In the illustratedembodiment, one plug 340 is shown in one cavity 351 of the plug magazine350. Embodiments wherein a plug 340 is in each cavity 351 are alsowithin the scope of this disclosure.

The plugs 340 may be of any suitable composition, shape, and/or size.For example, in some embodiments, the plugs 340 include, comprise, orconsist essentially of a bioabsorbable material. In some embodiments,the bioabsorbable material (or a portion thereof) is derived from animaltissue, such as pig skin or cow skin. In some embodiments, thebioabsorbable material is a collagen-containing material, such as agelatin foam from an animal source. In other or further embodiments, thebioabsorbable material (or a portion thereof) is a synthetic polymer,such as polylactic acid, polyglycolide, or poly(lactic-co-glycolicacid). In some embodiments, the plugs 340 include or consist essentiallyof a non-bioabsorbable material, such as polyvinyl alcohol or polyvinylacetate. In some embodiments, the plugs 340 include a dye. The dye mayfacilitate visualization of the plugs 340 when the plugs 340 aredisposed within the plug holder 330. In some embodiments, the plug 340may change colors when contacted with fluid (e.g., water or saline),thereby allowing a practitioner to visually determine when the plug 340has been wetted.

The plug 340 may be generally elongate in shape. For example, in someembodiments, the plug 340 is an elongate piece of material that has beenrolled into a substantially cylindrical shape of between 1 mm and 5 mm(e.g., approximately 2 mm) in diameter. The plug 340 may have a lengththat is at least two-fold, at least five-fold, and/or at least 10-foldlonger than the diameter of the plug 340. In some embodiments, the plugis between 10 mm and 30 mm (e.g., approximately 20 mm) in length.

The plugs 340 may be disposed within the plug magazine 350 in anysuitable manner. For example, in the depicted embodiment, the plugmagazine 350 is designed to accommodate a plurality of plug cartridges390, with each plug cartridge 390 housing a single plug 340. (Althoughonly one plug 340 is shown in the depicted plug magazine 350, thedepicted magazine 350 may hold three plugs 340, with one plug 340 ineach plug cartridge 390.) While the plug magazine 350 and the plugcartridges 390 are depicted as separate components, one of ordinaryskill in the art will recognize that, in some embodiments, the plugmagazine 350 and plug cartridges 390 may be combined into one integrallyformed component. For example, in some embodiments, the plug holder 330is an integrally formed component that does not include any apertures orgaps analogous to apertures 392 and an annular gap 336 shown in thedepicted embodiment.

In some embodiments, each of the cavities 351 of the plug magazine 350includes a distal portion that is sized to accommodate a plug cartridge390. In other words, a plug cartridge 390 may be disposed within adistal portion of each cavity 351. The plug cartridges 390 may begenerally elongate in shape with a hollow interior such that a flow path331, 332, or 333 extends longitudinally through each plug cartridge 390.

As shown in FIG. 17 , the plug cartridge 390 may include a distalprotrusion 398 (e.g., an annular protrusion) that contacts an innerdiameter of the cavity 351. In some embodiments, the distal protrusion398 contacts the inner diameter of the cavity 351 to form aninterference fit. In other embodiments, the distal protrusion 398 isattached to the plug magazine 350 via an adhesive. The size of theprotrusion 398 extending radially outward relative to the remainingportion of the plug cartridge 390, may be configured such that anannular gap 336 may be formed between an inner diameter of the plugmagazine 350 and an outer diameter of the plug cartridge 390. In someembodiments, the annular gap 336 is part of an alternative flow path inwhich fluid travels from the proximal end of the plug magazine 350,around the exterior surface of the plug cartridge 390, and through oneor more distal apertures 392 of the plug cartridge 390 to exit from theplug holder 330 without passing through the plug 340. However, in otherembodiments, no alternative flow path is available. Fluid flow in eitherdirection (proximal to distal or distal to proximal) through thisalternative flow path is within the scope of this disclosure. Further,one or more openings may be positioned between the proximal end of theplug cartridge 390 and a ledge 356 of the plug magazine (such as due toa longitudinal offset between the proximal end of the plug cartridge 390and the ledge 356) to allow fluid communication along the alternativeflow path.

In some embodiments, the plug cartridge 390 includes a frustoconicalsurface 361 adjacent its proximal end. The frustoconical surface 361 maydirect (e.g., funnel) fluid flow into a first flow path 331 as the plug340 is deployed as described below.

The plug cartridge 390 may also include a shoulder 394 that isconfigured to restrict proximal displacement of the plug 340 duringoperation of the medical device 300. In the depicted embodiment, theshoulder 394 is an annular protrusion that extends inward from the plugcartridge 390. The shoulder 394 may define a proximal portion of a plugcartridge lumen 391 that is relatively narrow in comparison to a distalportion of the plug cartridge lumen 391. In other words, a proximalportion of the plug cartridge lumen 391 that is defined by the shoulder394 may have a smaller diameter than a distal portion of the plugcartridge lumen 391.

The plug magazine 350 may include a ledge 356 adjacent a proximal end ofthe plug magazine 350. The ledge 356 may be designed to contact the plugcartridge 390, thereby preventing movement of the plug cartridge 390past the ledge 356. As described above, in some embodiments there may beoffsets, openings, or passageways that create fluid communicationbetween the portion of the first flow path 331 proximal of the ledge 356and the annular space or gap 336 between the plug cartridge 390 and theplug magazine 350.

The resilient adaptor 360 may be configured to receive the plug magazine350 and slide along the plug magazine 350 to sequentially deploy variousplugs 340. The resilient adaptor 360 may include a proximal portion 370,a distal portion 380, and one or more springs 365 disposed between theproximal portion 370 and the distal portion 380.

The proximal portion 370 of the resilient adaptor 360 may include aproximal adaptor 372 that is configured to couple to the distal end 324of the syringe body 320. For example, the proximal portion 370 mayinclude a female Luer connection that mates with a male Luer connectionat the distal end 324 of the syringe body 320 to form a fluid-tightconnection. The proximal portion 370 may also include a distallyextending frustoconical protrusion 376 and/or a lumen 374 that extendsthrough the proximal portion 370.

The distal portion 380 may include a distal adaptor 382. In the depictedembodiment, the distal adaptor 382 includes a male Luer lock connection.The distal adaptor 382 may be configured to couple to a proximal end ofan elongate tube, such as an introducer sheath or catheter, for deliveryof one or more plugs 340 into a patient. The distal portion 380 may alsoinclude a proximally extending frustoconical protrusion 386 and/or alumen 384 that extends through the distal portion 380.

The one or more springs 365 of the resilient adaptor 360 may be coupledto and extend between the proximal portion 370 and the distal portion380. For example, in the depicted embodiment, a first spring 365 a and asecond spring 365 b are disposed on opposite sides of a channel 362 thatextends between the springs 365 a, 365 b (see FIG. 6 ). When the one ormore springs 365 are in a resting state, the height of the channel 362may approximate (or be slightly shorter than) the height (h) of the plugmagazine 350. The width of the channel (w₁) may be at least as long asthe width (w₂) of the plug magazine 350. Note the reference numeral 365is used to refer to the springs 365 generally, while the numerals 365 aand 365 b refer specifically to springs on either side of the resilientadaptor 360 as shown in FIG. 6 . Further, the difference in heightbetween the height of the channel 362 and the height of the plugmagazine 350 may be configured such that the spring 365 exerts acompressive force on the plug magazine 350. This compressive force mayprovide a force associated with audible and/or tactile feedback when theplug magazine 350 is displaced with respect to the resilient adaptor 360(as further detailed below) and/or may provide a force associated withcreating a fluid-tight seal between portions of the plug magazine 350and resilient adaptor 360 (as also detailed below).

The spring 365 may be any suitable spring. For example, the spring 365may be made from any suitable material, such as an elastic polymer or awire. In the depicted embodiment, the spring 365 is a substantiallyplanar spring that is formed from an elastomeric material that has beenshaped or cut into a serpentine pattern. The material and shape of thespring 365 may allow it to stretch when tension is applied to both theproximal portion and the distal portion of the spring 365. Further, theresiliency of the spring 365 may bias the spring 365 to return to a morecompact configuration. Springs 365 of different shapes are also withinthe scope of this disclosure. Stated another way, the resilient adaptor360 may comprise a compliant mechanism comprising the spring 365 andother elements.

The plug magazine 350 may be disposed within the resilient adaptor 360as shown in the illustrated embodiment. In the configuration depicted inthe figures, the lumen 374 of the proximal portion 370 and the lumen 384of the distal portion 380 of the resilient adaptor 360 are aligned witha first flow path 331 that extends through the plug magazine 350.

To deploy a first plug 340 from the plug magazine 350, a practitionermay obtain a syringe that includes a plunger 310 and a syringe body 320that is filled with sufficient fluid in its reservoir 326 to deploy adesired number of plugs 340. The practitioner may then attach the plugholder 330 to the distal end 324 of the syringe body 320 and couple thedistal end of the plug holder 330 to an elongate tube, such as anintroducer sheath or catheter. The elongate tube may be in fluidcommunication with a void into which the plug 340 is to be inserted. Forexample, the distal end 324 of the syringe body 320 may be coupled to aproximal end of an introducer sheath used in a biopsy procedure asdescribed above. The practitioner may then advance the plunger 310toward a distal end 324 of the syringe body 320, thereby distallydisplacing fluid in the reservoir 326.

In some embodiments, as the fluid is displaced in a distal direction,the fluid may encounter the frustoconical surface 361 of the plugcartridge 390. The frustoconical surface 361 may direct (e.g., funnel)fluid along the flow path 331. As the fluid follows the first flow path331, the fluid may exert a distal force on the plug 340 disposed withinthe plug magazine 350, thereby causing distal displacement and ejectionof the plug 340 from the plug holder 330 into the elongate tube that isin fluid communication with the void. The fluid may also wet the plug340, which may increase the lubricity of the plug 340. In other words,the plug 340 may be hydrated as it is ejected from the plug holder 330.In some circumstances, wetting of the plug 340 may cause the plug 340 toswell. As the plunger is further advanced, the displaced fluid may pushthe plug 340 through the elongate tube and into the desired void. Theinserted plug 340 may serve any suitable purpose, such as obstructingfluid flow, inducing blood coagulation, and/or providing a scaffold topromote tissue growth.

Once the first plug 340 has been deployed, the plug holder 330 maytransition to a different configuration in which the lumen 374 of theproximal portion 370 and the lumen 384 of the distal portion 380 arealigned with a second flow path 332. To transition the plug holder 330to this configuration, the practitioner may apply a lateral force (F,see FIG. 5 ) on the resilient adaptor 360 while restraining movement ofthe plug magazine 350. As the lateral force is applied to the resilientadaptor 360, the frustoconical protrusion 376 may slide along a firstsloped surface 358, and the frustoconical protrusion 386 may slide alonga second sloped surface 359. Due to the direction of these slopedsurfaces 358, 359, the distance between the proximal portion 370 and thedistal portion 380 of the resilient adaptor 360 increases as theresilient adaptor 360 is initially displaced relative to the plugmagazine 350, thereby causing extension of the spring 365.

As the resilient adaptor 360 approaches the second flow path 332, thefrustoconical protrusions 376, 386 may slide along a third slopedsurface 368 and a fourth sloped surface 369 such that the resilientadaptor 360 is guided to a position in which the proximal lumen 374 andthe distal lumen 384 are aligned with the second flow path 332. Thespring 365 may provide a force that facilitates seating of thefrustoconical protrusions 376, 386 in the region occupied by the slopedsurfaces 368, 369. For example, in some embodiments, the spring 365 maycause the plug holder 330 to snap into place, thereby providing thepractitioner with tactile and/or audible feedback that the resilientadaptor 360 is properly aligned for deployment of another plug 340.

Once the resilient adaptor 360 is positioned such that the proximallumen 374 and the distal lumen 384 are aligned with the second flow path332, the practitioner may deploy the second plug 340 in a manneranalogous to that described above in connection with the first plug 340.The resilient adaptor 360 may be further slid relative to the plugmagazine 350 to enable deployment of a third plug 340. A skilled artisanwill recognize that plug magazines 350 that include any number of plugs340 are contemplated and within the scope of this disclosure.

Additionally, the spring 365 may provide a compressive force that tendsto force the frustoconical protrusions 376, 386 of the resilient adaptor360 into contact with the mating sloped surfaces (358, 359 when themagazine 350 is in the position shown in the figures) such that themating surfaces, and the force applied thereon, form a fluid-tight sealwhen the proximal lumen 374 and the distal lumen 384 are aligned withone of the flow paths 331, 332, 333. This may facilitate use of theassembly without additional seals such as o-rings.

Any methods disclosed herein include one or more steps or actions forperforming the described method. The method steps and/or actions may beinterchanged with one another. In other words, unless a specific orderof steps or actions is required for proper operation of the embodiment,the order and/or use of specific steps and/or actions may be modified.Moreover, sub-routines or only a portion of a method described hereinmay be a separate method within the scope of this disclosure. Statedotherwise, some methods may include only a portion of the stepsdescribed in a more detailed method.

Reference throughout this specification to “an embodiment” or “theembodiment” means that a particular feature, structure, orcharacteristic described in connection with that embodiment is includedin at least one embodiment. Thus, the quoted phrases, or variationsthereof, as recited throughout this specification are not necessarilyall referring to the same embodiment.

Similarly, it should be appreciated by one of skill in the art with thebenefit of this disclosure that in the above description of embodiments,various features are sometimes grouped together in a single embodiment,figure, or description thereof for the purpose of streamlining thedisclosure. This method of disclosure, however, is not to be interpretedas reflecting an intention that any claim requires more features thanthose expressly recited in that claim. Rather, as the following claimsreflect, inventive aspects lie in a combination of fewer than allfeatures of any single foregoing disclosed embodiment. Thus, the claimsfollowing this Detailed Description are hereby expressly incorporatedinto this Detailed Description, with each claim standing on its own as aseparate embodiment. This disclosure includes all permutations of theindependent claims with their dependent claims.

Recitation in the claims of the term “first” with respect to a featureor element does not necessarily imply the existence of a second oradditional such feature or element. It will be apparent to those havingskill in the art that changes may be made to the details of theabove-described embodiments without departing from the underlyingprinciples of the present disclosure.

We claim:
 1. A delivery device for delivering compositions or medicalarticles to a patient, the delivery device comprising: a rotatablemagazine defining: a central lumen that extends through the rotatablemagazine; and a plurality of chambers disposed around the central lumen;a frame comprising a proximal channel, a distal channel, and aconnecting region disposed between the proximal channel and the distalchannel; and an elongate shaft that both extends through the centrallumen of the rotatable magazine and is coupled to the frame; whereinrotation of the rotatable magazine about the elongate shaft causes thedelivery device to transition from a first configuration in which afirst chamber of the plurality of chambers is aligned with both theproximal channel and the distal channel to a second configuration inwhich a second chamber of the plurality of chambers is aligned with boththe proximal channel and the distal channel; and wherein each chamber ofthe plurality of chambers includes a primary channel and a bypasschannel, wherein the bypass channel provides a fluid flow path aroundthe primary channel.
 2. The delivery device of claim 1, wherein thedistal channel and the proximal channel are co-linear with one another,but are not co-linear with the connecting region.
 3. The delivery deviceof claim 1, wherein the frame provides a compressive force forfacilitating a fluid-tight seal between the frame and a chamber of theplurality of chambers of the rotatable magazine.
 4. The delivery deviceof claim 1, wherein a first end of the elongate shaft is attached to theframe, and a second end of the elongate shaft that is disposed oppositethe first end is not attached to the frame.
 5. The delivery device ofclaim 4, wherein the frame comprises a cavity for receiving the secondend of the elongate shaft, wherein the cavity is elongate in shape topermit deflection of the frame as the delivery device transitions fromthe first configuration to the second configuration.
 6. The deliverydevice of claim 1, wherein the frame comprises at least one notch thatcreates a flex point on the frame.
 7. The delivery device of claim 1,wherein the rotatable magazine further comprises a third chamber.
 8. Thedelivery device of claim 1, further comprising a syringe that isconfigured to couple to a proximal adaptor of the frame.
 9. The deliverydevice of claim 1, wherein interaction between the rotatable magazineand the frame provides audible and/or tactile feedback to indicate thatone of the plurality of chambers is aligned with both the proximalchannel and the distal channel of the frame.
 10. The delivery device ofclaim 1, wherein the rotatable magazine is rotatable about the elongateshaft in only a single direction.
 11. The delivery device of claim 10,further comprising a stop that is configured to prevent more than onerotation of the rotatable magazine about the elongate shaft.
 12. Thedelivery device of claim 1, wherein the frame comprises a first hub witha first plurality of spokes extending therefrom and a second hub with asecond plurality of spokes extending therefrom, wherein each spoke iscoupled to a cap that is configured to interact with a chamber toprevent a composition from escaping from the chamber.
 13. The deliverydevice of claim 1, wherein the delivery device is structured to:maintain a medical plug within the chamber when a proximally directedflow of fluid passes through the chamber; and permit deployment of themedical plug when a distally directed flow of fluid passes through thechamber.
 14. The delivery device of claim 1, further comprising acartridge disposed within each chamber of the plurality of chambers,wherein each cartridge defines a shoulder adjacent a proximal end of thecartridge, the shoulder being configured to engage a medical plug andrestrict movement of the medical plug proximal of the shoulder.
 15. Thedelivery device of claim 1, further comprising a plurality of medicalplugs, wherein one medical plug of the plurality of medical plugs isdisposed within each chamber of the rotatable magazine.
 16. The deliverydevice of claim 1, wherein each chamber of the plurality of chambers ispreloaded with a medicament.
 17. A medical plug delivery assemblycomprising: a fluid delivery device; a frame configured for coupling toa distal end of the fluid delivery device, the frame comprising a distalchannel; and a rotatable magazine defining a plurality of chambers,wherein each chamber of the plurality of chambers is configured toreceive a medical plug; wherein the rotatable magazine is disposedbetween a distal portion of the frame and a proximal portion of theframe that together provide a compressive force on the rotatablemagazine to form a fluid-tight seal between the frame and a chamber ofthe plurality of chambers of the rotatable magazine; and whereinrotational displacement of the rotatable magazine with respect to theframe transitions the assembly from a first configuration in which afirst chamber of the plurality of chambers is in fluid communicationwith the distal channel of the frame to a second configuration in whicha second chamber of the plurality of chambers is in fluid communicationwith the distal channel of the frame; and wherein each chamber of theplurality of chambers includes a primary channel and a bypass channel,wherein the bypass channel provides a fluid flow path around the primarychannel.
 18. The medical plug delivery assembly of claim 17, whereineach chamber of the plurality of chambers is configured to maintain amedical plug within the chamber when a proximally directed flow of fluidpasses through the chamber and wherein the medical plug is deployedthrough the distal channel of the frame when a distally directed flow offluid passes through the chamber.